Follow-Up Care for Survivors of Lymphoma Who Have Received Curative-Intent Treatment

Abstract

Objective This evidence summary set out to assess the available evidence about the follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment. MethodsThe medline and embase databases and the Cochrane Database of Systematic Reviews were searched for evidence published between 2000 and August 2015 relating to lymphoma survivorship follow-up. The evidence summary was developed by a Working Group at the request of the Cancer Care Ontario Survivorship and Cancer Imaging programs because of the absence of evidence-based practice documents in Ontario for the follow-up and surveillance of asymptomatic patients with lymphoma in complete remission.Results Eleven retrospective studies met the inclusion criteria. The proportion of relapses initially detected by clinical manifestations ranged from 13% to 78%; for relapses initially detected by imaging, the proportion ranged from 8% to 46%. Median time for relapse detection ranged from 8.6 to 19 months for patients initially suspected because of imaging and from 8.6 to 33 months for those initially suspected because of clinical manifestations. Only one study reported significantly earlier relapse detection for patients initially suspected because of clinical manifestations (mean: 4.5 months vs. 6.0 months, p = 0.042). No benefit in terms of overall survival was observed for patients depending on whether their relapse was initially detected because of clinical manifestations or surveillance imaging. SummaryFindings in the present study support the importance of improving awareness on the part of survivors and clinicians about the symptoms that might be associated with recurrence. The evidence does not support routine imaging for improving outcomes in this patient population.

Etiopathogenic, Epidemiologic and Clinical-Therapeutic Comparison of Non-Hodgkin’s Lymphoma and Kaposi’s Sarcoma

“…The high prevalence of men with NHL described in the literature was also found in this work when compared with KS 6,[19][20][21] . Although NHL is more common in the elderly, in this study, when this disease was associated with the presence of HIV, the age has not surpassed 34 years.…”

Toward equitably high-quality cancer survivorship care

“…Various national cancer control organizations and advocacy groups, for example, defined it as beginning at diagnosis and continuing for the remainder of one's life (see for example, Canadian Partnership Against Cancer [CPAC], 2012; Ristovski-Slijepcevic, 2008; University Health Network [UHN], n.d.). Mid-range definitions positioned it as beginning at the conclusion of primary treatment and lasting until recurrence or end of life (see for example, Howell et al, 2011;Sussman et al, 2016). The narrowest definitions targeted the transition between active treatment and primary care (see for example, Chomik, 2010;Ward, Doll, Ristovski-Slijepcevic, Kazanjian, & Golant, 2010).…”

Les soins aux survivants du cancer : vers une grande qualité, en toute équité

“…Par exemple, pour plusieurs groupes de défense des droits et organismes nationaux de lutte contre le cancer, la survivance s'étend du diagnostic à la fin de vie du patient (voir entre autres le PCCC, 2012; Ristovski-Slijepcevic, 2008; Réseau universitaire de santé, sans date). Des définitions intermédiaires la font commencer à la fin du traitement primaire, et se poursuivre jusqu'à la récidive ou le décès (voir Howell et al, 2011;Sussman et al, 2016), alors que d'autres, plus restreintes, n'incluent que la période de transition entre le traitement actif et les soins de première ligne (voir par exemple Chomik, 2010;Ward, Doll, Ristovski-Slijepcevic, Kazanjian et Golant, 2010). Si « tout le monde est un survivant », il devient difficile d'identifier les personnes dont la situation ou les besoins sont complexes, ce qui peut avantager les patients mieux outillés pour trouver réponse à leurs besoins, peu importe la complexité de leur cas ou les ressources d'autosoin.…”